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As private health maintenance organizations (HMOs) and government-sponsored agencies (eg, Department of Health and Human Services [DHHS] and the Centers for Medicare and Medicaid Services [CMS]) seek to provide quality medicine cost-effectively, reduction in the ordering of “unnecessary” laboratory tests has become a favorite target of these efforts. The critical question facing physicians, however, is: What constitutes an unnecessary laboratory test? In the current climate of business-oriented medicine, the answer should not be Any test for which reimbursement by a payer (eg, Medicare) is likely to be denied. The correct answer is Any test for which the results are not likely to be “medically necessary” in the appropriate management of the patient’s medical condition. Thus, it is incumbent upon physicians and laboratorians to understand which laboratory tests are appropriate to order in the diagnosis and follow-up of a patient’s medical condition.